Prevalence of oral mucosal lesions in an elderly population in the city of Valparaiso, Chile

Changing trends in oral mucosal diseases in China (2016-2024): a cross-sectional study of 316,166 patients with focus on COVID-19 impact and use of chinese patent medicines

BACKGROUND

Oral mucosal health is a critical component of overall oral health and impacts an individual's quality of life. Despite variations in prevalence rates of oral mucosal diseases across regions, previous studies often involved small sample sizes with insufficient data analysis. This study addresses the gap by providing a comprehensive analysis of the changing spectrum of oral mucosal diseases in China, with a focus on the impact of COVID-19. It also explores trends in the use of Chinese patent medicines (CPMs) for treatment.

METHODS

This retrospective, cross-sectional study included 316,166 patients from the Department of Oral Medicine at Peking University School and Hospital of Stomatology between 2016 and 2024. Data on patient demographics, chief complaints, diagnoses, and the use of CPMs were collected and analyzed. Statistical comparisons were made using t-tests and chi-square tests, with significance set at P < 0.05.

RESULTS

The average patient age was 49.42 ± 17.92 years, and women were significantly overrepresented (male/female ratio: 0.59). The most frequent diagnoses were oral lichen planus and recurrent aphthous stomatitis, accounting for the top two positions each year. The study found significant differences in disease patterns among age groups, with oral potentially malignant disorders like oral lichen planus becoming more prevalent in older populations. CPMs were used by 52.29% of patients, with similar proportions using topical and systemic treatments. During the COVID-19 pandemic (2020-2022), the number of patients dropped significantly, and an increased prevalence of burning mouth syndrome and oral candidiasis was observed.

CONCLUSION

This study offers the largest amount of valuable epidemiological data on the management of oral mucosal diseases to date in China, underscoring the need for targeted health resource allocation. An important trend was the greater predilection for females and middle-aged and elderly populations. The top three diseases in terms of number of patients were oral lichen planus, recurrent aphthous stomatitis, and oral candidiasis. The treatment data indicated widespread use of CPMs for oral mucosal diseases. The COVID-19 pandemic was associated with a significant decrease in the number of total patients and was also characterized by an increase in the proportion of patients with diseases that have psychosomatic associations. The impact of the COVID-19 pandemic and the widespread use of CPMs warrant further investigation in future studies to ensure evidence-based medical practices.

CLINICAL TRIAL NUMBER

Not applicable.

A rural teledentistry care experience: a geriatric approach to assessing oral health status and treatment needs in older adults from a Mapuche community in Chile

Background

Limited attention has been given to oral health challenges faced by older Indigenous populations, especially in rural settings, where disparities exist. This study aims to assess oral health in a rural Mapuche community in southern Chile, utilizing geriatric technology support, and exploring the connection between geriatric health and oral well-being to fill a gap in this context.

Methods

A cross-sectional study was conducted involving 76 independent older adults from a rural Mapuche community who required dental care. Assessments were in a remote care setting gathering extensive data including comprehensive geriatric assessments, medical and dental conditions using a geriatric teledentistry platform (TEGO®). Statistical analysis involved descriptive analysis, logistic regression, and both multiple correspondence analysis and k-means cluster analysis.

Results

The sample comprised individuals with limited formal education and a high degree of vulnerability. Geriatric assessments unveiled cognitive deterioration, frailty, depression risk, and multimorbidity. A distribution of the DMFT index, number of remaining teeth, number of occluding pairs, number of teeth with restorative needs and other relevant clinical findings was conducted based on sociodemographic, and medical-geriatric-dental characteristics, and additionally, a Multinomial Logistic Regression Analysis of Dentition Variables in Relation to Geriatric Assessments was performed. The dental burden was substantial, with an average DMFT index of 25.96 (SD 4.38), high prevalence of non-functional dentition (89.3%), periodontal disease (83%), xerostomia (63.2%) and oral mucosal lesions (31.5%). Age, lower education, depression, daily medication number and sugary consumption frequency were associated with a decreased average number of teeth (p < 0.05). Multiple correspondence analysis and k-means cluster analysis identified 4 clusters, with the edentulous and functional dentition groups being the most distinct.

Conclusion

This study uncovers a substantial dental burden and intricate medical-geriatric conditions interlinked among Indigenous older adults in a rural Chilean Mapuche community. The implementation of a geriatric technological ecosystem in the community enabled the resolution of less complex oral health issues and facilitated remote consultations with specialists, reducing the necessity for travel to health centers. This underscores the need for innovative dental public health initiatives to address health disparities and improve the overall well-being of older Indigenous adults.

Scientific evidence on the efficacy of effervescent tablets for cleaning removable prostheses. A systematic review and meta-analysis

STATEMENT OF PROBLEM

Scientific evidence to determine the optimal method of cleaning and disinfecting removable prostheses is lacking.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of effervescent tablets in the cleaning and sanitizing of removable prostheses compared with other chemical and physical methods by assessing the reduction of biofilm, microbial levels, and material stability.

MATERIAL AND METHODS

A systematic literature search and meta-analysis was conducted in August 2021 in the MEDLINE/PubMed, Cochrane, Embase, Scopus, and Web of Science databases. Randomized and nonrandomized controlled clinical trials published in English were included without publication year limits. A total of 23 studies were included in the systematic review and 6 in the meta-analysis, which had been registered in the international prospective register of systematic reviews (PROSPERO) database (CRD42021274019). The Cochrane Collaboration tool was used to assess the risk of bias of randomized clinical trials. The physiotherapy evidence database (PEDro) scale was used to analyze the internal validity of clinical trials by assessing the quality of the data obtained. The studies included in the meta-analysis were combined by using a random-effects model with the inverse variance method. Publication bias was analyzed by using the Duvall and Tweedie trim-and-fill method.

RESULTS

With regard to biofilm reduction, the standardized mean difference estimated with the 4 studies combined in the meta-analysis was P=.012: mean difference=-1.92; 95% confidence interval=-3.45 to -0.38, indicating a "large" effect of the combination of brushing and effervescent tablet versus brushing alone. To estimate the reduction in the total bacteria levels in the 3 combined studies, a "large" effect size was obtained for the combination of brushing and using an effervescent tablet versus brushing alone, P<.001: mean difference=-4.43; 95% confidence interval=-8.29 to -0.55. Finally, when the 3 studies were combined to assess the reduction of Candida or fungal infection, a "moderate" effect size was obtained for the combination of brushing combined with the use of an effervescent tablet, P<.001: mean difference=-0.78; 95% confidence interval=-1.19 to -0.37.

CONCLUSIONS

The combination of brushing and the use of effervescent tablets versus brushing alone had a significantly higher effect on reducing biofilm and bacterial counts and a moderate effect on reducing Candida. Regarding color and dimensional stability, few studies were found, with the results depending on the concentration of the product and the immersion time of the device.

Different wavelengths of laser: are they significant for treatment of denture stomatitis?: an in-vitro study

BACKGROUND

Denture stomatitis (DS) is an inflammatory disorder that affects the mucosal surface underneath the dentures and frequently causes oral mucosal irritation, discomfort, and altered taste perception, which prevents people from consuming enough nutrients. One of the main causes of DS is an overgrowth of the fungus Candida albicans (C. albicans). A possible alternative treatment for Candida infections is thought to be laser therapy. The aim of this study was to evaluate how different wavelengths of laser would affect growth and pathogenic properties of Candida albicans.

METHODS

A concentration of 106 viable cells/ml of Candida albicans were used in the preparation process. Four groups were created from the specimens. Culturing of the control group was completed with no intervention. The other 3 groups received laser radiation for 60 seconds at a power of 1W. The 2nd and 3rd groups were irradiated with diode laser at a wavelength of 940 nm and 980 nm respectively. The 4th group was irradiated with Nd-YAG laser at a wavelength of 1064 nm. Turbidimetric growth was defined as variations in the optical density of fungal growth. These measures were made at three different times: baseline, 48 hours, and 72 hours.

RESULTS

In both groups of diode laser, the growth of Candida albicans showed no remarkable differences at baseline, after 48 and 72 hours using a power of 1 W and duration of 60 seconds. The Nd-YAG group showed significant increase in optical density after 48 hrs then significant decrease after 72 hrs. The optical density values in the control group showed no notable difference between the control and diode study groups at different time periods. However, the Nd:YAG group showed a statistically significant difference compared to the control and the 2 diode laser groups.

CONCLUSIONS

Different laser parameters have a different effect on growth and pathogenic properties of Candida albicans. Diode laser therapy with wavelengths 940 and 980 nm used in continuous mode with power of 1 W for duration of 60 seconds can result in proliferation of Candida albicans instead of destroying them. Nd:YAG laser, used in pulsed mode, with power of 1 W for a duration of 60 seconds can be used to destroy Candida albicans and therefore, can be used as an effective treatment for denture stomatitis.

Medium-chain fatty acids as an alternative treatment for denture stomatitis in older people

OBJECTIVE

To determine the effect of medium-chain fatty acids (MCFA) on the severity of denture stomatitis (DS) and the counts of Candida spp. in older people (OP) wearing removable prostheses (RP).

MATERIALS AND METHODS

This randomized, controlled and triple-blind study included forty-three OP presenting DS. The control group was treated with 0.12% chlorhexidine (CHX) and the experimental group with MCFA, 2 × /day for 15 days. Intraoral examination and counts of Candida spp. were performed at 0, 7, and 15 days. The differences between both groups in the decrease of the severity of DS and the viability of Candida spp. were determined clinically and microbiologically, respectively.

RESULTS

OP carriers of RP treated with MCFA presented remission of the clinical signs of DS, but the Candida spp. counts only decreased significantly in the CHX-treated group at 7 days of treatment (p < 0.05). Besides, MCFA was shown to reduce the clinical signs of DS after the first week of application, while CHX after the second week.

CONCLUSIONS

The MCFA is effective in reducing the clinical signs of DS associated with oral candidiasis in subjects with RP. Both treatments showed a significant decrease in severity, for MCFA after the first week and for CHX two weeks after starting the corresponding treatment.

CLINICAL RELEVANCE

The MCFA is an effective, harmless, and accessible treatment alternative against DS, since it manages to reduce the severity of the lesion in the milder cases of DS in the oral mucosa of OP carriers of RP.

Prevalence and risk factors of potentially malignant disorders of the mucosa in the general population: Mucosa lesions a general health problem?

AIM

Oral cancer mostly develops from oral mucosa regions with morphological alterations transforming malignant. These visible precancerous mucosa lesions are named potentially malignant disorders (PMD). We aimed to analyze the prevalence of PMD and its risk factors for PMD in a population-based sample in Northern Germany.

MATERIAL AND METHODS

Data of 6078 individuals from the population-based Study of Health in Pomerania (SHIP) was used. PMD were photographically documented and periodontal health was assessed in a standardized procedure.

RESULTS

PMD were observed in 54 individuals (0.9%). The most prevalent PMD was homogenous leukoplakia (n = 37) followed by Lichen ruber (n = 9). Smoking (Odds Ratio (OR) 2.70; 95% confidence interval (CI): 1.24-5.87), male sex (OR 3.32; 95%-CI: 1.77-6.21), type 2 diabetes mellitus (OR 2.07; 95%-CI: 1.08-3.98) and body mass index (OR 1.09; CI 1.04-1.14) were significantly associated with PMD, with the corresponding area under the curve (AUC) being 0.696 (CI: 0.655; 0.737).

CONCLUSION

Our results suggest a clinically relevant prevalence of PMD in the population. We identified male sex, type 2 diabetes mellitus, current smoking, and obesity as risk factors. We recommend photographic documentation and intensified training of medical and dental staff to detect and monitor PMD.

High prevalence of oral mucosal lesions in elderly: Call for revolutionizing geriatric dental care strategies

Context:

World'spopulation is ageing and increase in geriatric population demands improved oral health care. Previous epidemiologic studies in general population of India and particularly in Kerala (state with maximum proportion of elderly) provided very little information about oral mucosal lesions in elderly.

Aims:

To find out the prevalence, pattern and distribution of oral mucosal lesions in geriatric patients and to explore their association with different study variables.

Settings and Design:

A descriptive, hospital-based, cross sectional study was conducted for a period of 9 months in the out-patient clinic, Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (tertiary healthcare centre in Kerala, India).

Methods and Materials:

Participants aged 60 and above were selected by consecutive sampling. Data were collected through clinical examination and by using a structured proforma.

Statistical Analysis Used:

Descriptive statistics with tests of significance of associations were done.

Results:

The geriatric population (N=750, 66.89 ± 6.07, M: F=1.4:1), was recruited by screening 43,180, and 447 (67.29 ± 6.15, M: F=2:1) were identified having oral mucosal lesions withprevalence of 59.6% (95% CI=56.05–63.05). Most common lesion group was red and white (73.2%), followed by pigmented (15.5%). Oral mucosal lesions were significantly associated with age over 65, male gender, presence of habit and denture usage (P < 0.05).

Conclusions:

The prevalence of oral mucosal lesions in geriatric people is high. Hence setting up of geriatric dental clinics, with appropriate preventive and palliative intervention strategies is mandatory.

Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and meta-analysis

OBJECTIVE

The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis.

METHODS

This review identified studies comparing the efficacy of microwave prosthesis disinfection (I) to topical antifungal therapy (C) in the treatment of denture stomatitis (O), which included only individuals who used complete dentures and presented with denture stomatitis (P). The search was performed in six databases and identified 1524 records; after the removal of duplicates, 816 articles remained. Three articles were selected for qualitative synthesis and two for meta-analysis. Random-effects meta-analysis estimated the polled effects of microwave disinfection and antifungal therapy on the Candida counts and clinical manifestation of denture stomatitis. The GRADE approach was used to estimate the certainty of evidence.

RESULTS

All included studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin. Significative differences between treatments were only detected for Candida quantification in the palate, within 90 days follow-up period (SMD = 0.47, 95% CI = 0.02-0.91). Meta-analyses did not show any further differences between treatments (p > .05), considering the Candida quantification in dentures and the frequency of clinical signs of denture stomatitis. The certainty of the evidence was considered as low, according to GRADE approach.

CONCLUSION

Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.

Prevalence of Oral Mucosal Lesions and Relation to Serum Cotinine Levels-Findings from a Cross-Sectional Study in South Africa

Oral mucosal lesions (OML) can decrease oral health-related quality of life and some have the potential to become malignant. The aim of the present study was to report the prevalence of OML in relation to age, sex, and serum cotinine levels in a population with mixed ancestry from South Africa. This study is part of the Cape Town Vascular and Metabolic Health (VHM) study, conducted between 2014-2016. Trained dental examiners assessed the oral mucosa for the presence of OML according to WHO criteria. In total, 1976 individuals were included in the study, being 1496 females (75.7%) and 480 males (24.3%) with average age of 49.5 years (SD = 15.3). In total, 262 lesions were detected in 252 participants (overall prevalence of 13%). Males had higher prevalence than females (14% vs. 9%, p = 0.008). Participants aged 25-34 had the highest prevalence rates (21%). Participants who had cotinine ≥15 ng/mL had higher prevalence of OML as compared to those with <15 ng/mL (15% vs. 5%, p < 0.001). Most common lesions were nicotine stomatitis (33%) and leukoplakia (19%). Age, male sex, and higher cotinine levels were associated with increased prevalence of OML.

The relationship of oral mucosal lesions and removable prostheses: Quantitative and qualitative study

Background/Aim: The aim of this study was to determine the development and distribution of denture-related oral mucosal lesions in patients using removable prosthesis by using quantitative and qualitative research methods. Material and Methods: A 21-item structured questionnaire form was used. Then, patients were evaluated for the presence and types of oral lesions. In the qualitative phase of the study, two focus group interviews were conducted with volunteers among participants of the quantitative part. The quantitative data were first evaluated by the Kolmogorov-Smirnov test for normal distribution. Chi-square test, Mann Whitney U test, t-test and logistic regression were used for statistical evaluation. Qualitative data analysis was manually performed by the content analysis method. Results: This study included 171 subjects. When the participants were classified as lesion and non-lesion groups, cigarette use and duration of prosthesis use were higher in patients with lesions. Denture-related lesions occurred in 46.2% of the participants; prosthetic stomatitis in 23.9% of the denture-related lesions, traumatic ulcer in 12.9%, epulis fissuratum in 9.9%, and angular cheilitis in 5.8%. Of the participants with lesions 72% (n=57) had a single lesion, while 28% (n=22) had multiple lesions. The duration of prosthesis use was longer in patients with lesions (p=0.022). The main themes determined in the qualitative stage were identified as "views on prosthesis use", "features related to prosthesis care", "information sources on prosthesis" and "proposals of participants". Conclusions: Current study shows that denture-related lesions are very common. Patients should be informed in detail and adequately by physicians and specialized nurses in this regard at every stage of treatment. A universal protocol will be very helpful to ensure that patients are provided with all necessary information about wearing dentures, their maintenance and the importance of regular check-ups. Informative meetings should be organized for wider patient groups in which patients may also interactively participate in, and studies to increase oral health literacy should be conducted. The cross-sectional assessment is not enough for risk assessment due to its nature and only declaration based assessment might miss the relations. Follow-up studies combined with qualitative studies with different approaches are needed.

The effect of low level laser on number of Candida albicans colonies in-vitro: a new finding

Background

Candida albicans is a commensal organism that causes a wide variety of diseases in humans. One of these diseases is oral candidiasis, which occurs at a high recurrence rate in spite of available treatments. The purpose of this study was to compare the effect of low-level laser therapy (LLLT) with the use of nystatin on in-vitro growth of Candida albicans.

Method

We prepared two samples of Candida albicans at different concentrations: 10⁴ viable cells/ml and 10⁶ viable cells/ml. Specimens from each sample were divided into a control group, a nystatin-treated group, and a group treated with LLLT. The control group was cultured without any intervention. The second group was treated with nystatin and the solution was vibrated for 30 s or 60 s. The third group was irradiated with a gallium-aluminum-argon (Ga-Al-Ar) diode laser (Epic 10; Biolase Inc.)in continuous mode using a wavelength of 940 nm and a power of 1 W for 30 s or 60 s (38 J/cm² and 76 J/cm²). The specimens from the nystatin group and the LLLT group were cultured and the number of colony-forming units (CFU/ml) for each group was counted and compared.

Results

Nystatin completely eliminated the colonies (0 colonies) in all specimens. There was an increase in the number of colonies in the LLLT group for both cell concentrations at 30 s and at 60 s. However, this increase was statistically significant only for a concentration of 10⁴ viable cells/ml at an exposure time of 30s. The increase in the concentration of 10⁶ viable cells/ml at both 30 s and 60 s was statistically significant compared with the control group, although the highest number of colonies remained after an exposure time of 60s.

Conclusion

LLLT led to an increase in the growth of Candida colonies. However, there was no significant difference related to the exposure time between the different cell concentrations.

Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly

This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.

Prevalence and Distribution of Oral Mucosal Lesions by Sex and Age Categories: A Retrospective Study of Patients Attending Lebanese School of Dentistry

Background

Prevalence and distribution of oral mucosal lesions in a sample of Lebanese population attending the School of Dentistry of Lebanese University is necessary to evaluate their oral health situation.

Objectives

The aim of the present study was to determine the prevalence and distribution of oral mucosal lesions of patients attending the School of Dentistry.

Methods

A descriptive study was carried out by retrospectively examining a total of 231 medical and clinical examination record files of patients, attending the School of Dentistry Lebanese University for multidisciplinary dental treatments. 178 medical records were retained. Each medical and clinical examination record was done by an undergraduate student and then evaluated by a doctor. The record file included a civil status, chief complaint, medical history, and extraoral and intraoral clinical examination during the period between October 2014 and May 2015. Exclusion criteria were lack of written information in their medical and clinical examination record and being nonevaluated by a doctor. Data regarding age, gender, socioeconomic status, chief complaint, systemic diseases, and drugs intake were collected by using a questionnaire while the type of extraoral and oral mucosal lesions by clinical examination.

Results

The sample consisted of 102 (57.3%) females and 76 (42.7%) males. The age ranged from 10 to 92 years with a mean age of 40.1 years. Among these subjects, 110 (61.8%) presented with one or more lesions. All patients were Lebanese. The most common lesion diagnosed was coated/hairy tongue affecting 17.4% of the subjects, followed by melanotic macule (11.2%), gingivitis (9.6), linea alba (6.2%), tongue depapillation (5.1), leukoplakia (5.1), traumatic fibroma (4.5), frictional keratosis (3.9%), fissured tongue (3.9%), hemangiomas (3.9%), Fordyce granules (3.9%), dry mucosa (3.4), angular cheilitis (2.2), gingival hyperplasia (2.2), and crenulated tongue (1.7%). Overall, the prevalence of oral mucosal lesions did not significantly differ between sex and age groups.

Conclusions

The high prevalence of oral mucosal lesions necessitates adequate awareness and management of these lesions in the general population. Dental clinicians should be knowledgeable and familiar with the etiopathogenesis, clinical presentation, diagnosis, and management of these lesions.

Oral diseases: a 14-year experience of a Chilean institution with a systematic review from eight countries

Background

Retrospective studies to assess the distribution of oral diseases (ODs) are helpful in estimating the prevalence of oral diagnoses in the population, and thus help in preventive and curative services. Prevalence and frequency data for ODs are available from many countries, but information from Chile is scarce.

Material and Methods

This study investigated the frequency of ODs in a Chilean population. For this, we included all patients treated at the University of Talca (UTALCA, Chile) between 2001 and 2014. Patient characteristics were retrieved from medical files. To contextualize our results, we conducted a systematic review (SystRev) using Publish or Perish software (PoP), Google Scholar and MEDLINE/PubMed.

Results

One hundred sixty-six ODs were diagnosed, and the most prevalent groups were soft tissue tumours, epithelial pathology and salivary gland pathology. Individually, irritation fibroma, oral lichen planus (OLP) and mucocele were the most common diagnoses. ODs frequently affected unspecified parts of the mouth (including cheek, vestibule and retromolar area), gum, lips, tongue and palate. In the SystRev, the more studied diagnoses were leukoplakia, OLP and recurrent aphthous stomatitis; prevalent lesions included Fordyce’s spots, recurrent aphthous stomatitis and fissured tongue. Chilean patients and SistRev shared almost all ODs.

Conclusions

The results reflect ODs diagnosed in a specialized service of oral pathology and medicine in Chile and will allow the establishment of preventive/curative policies, adequate health services and dentistry curriculum.

Key words:Stomatognathic diseases, mouth diseases, oral mucosal lesions, epidemiology, Chilean population, retrospective cohort study.

Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries

BACKGROUND

The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population.

MATERIAL AND METHODS

It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn.

RESULTS

The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%).

CONCLUSIONS

The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words:Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review.

Impact of Denture Cleaning Method and Overnight Storage Condition on Denture Biofilm Mass and Composition: A Cross-Over Randomized Clinical Trial

BACKGROUND

Appropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures.

METHODS

In a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i) brushing and immersion in water without a cleansing tablet, (ii) brushing and immersion in water with a cleansing tablet, (iii) ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv) ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control) and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20), and of Candida albicans were identified using the Polymerase Chain Reaction (PCR) technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%.

RESULTS

Overnight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01). The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores.

CONCLUSIONS

The use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to brushing.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02454413.

Oral mucosal lesions in elderly dental patients in Sana'a, Yemen

OBJECTIVES

With aging, the oral mucosa becomes more susceptible to external stimuli. The aims of this study were to obtain baseline data on the prevalence of oral mucosal lesions (OMLs) in a population of elderly Yemeni patients and to investigate differences in the presentation of these findings in relation to age, gender, education level, and the wearing of dentures.

PATIENTS AND METHODS

The prevalence of OMLs was assessed by clinical examination of a sample of 310 elderly Yemeni patients aged 60 years and older. A single examiner performed detailed oral examinations of the oral cavity according to international criteria and the World Health Organization codes.

RESULTS

The overall prevalence of OMLs was 77.1%, with a significant difference (P < 0.05) between men (80.3%) and women (69.6%). The prevalence rate of OMLs indicated a significant decrease with advancing age. The most frequently observed lesions were fissured tongue (34.2%), benign tumors (17.1%), hairy tongue (16.5%), and qat-induced white lesions (12.6%). Hairy tongue, qat-induced white lesions, and shammah keratosis were associated with men (P < 0.01, P < 0.05, and P < 0.05, respectively), whereas geographic tongue was associated with women (P < 0.05). The presence of one or more lesions was significantly associated with low education level (P < 0.05). Certain OMLs showed a significant association with smoking and qat chewing (P < 0.05). No association was found between the occurrence of OMLs and denture wearing (P > 0.05).

CONCLUSIONS

The present study has shown a high prevalence of oral lesions among Yemeni elders.

Geriatric oral lesions: A multicentric study

AIM

To carry out an oral biopsy survey in geriatric patients from the participating institutions.

METHODS

The biopsy records of the participating institutions were reviewed for oral lesions from patients aged 65 years and older diagnosed from 2003 to 2012. Demographic data and the site of the lesions were collected. Histopathological diagnoses were categorized into two categories: non-neoplastic lesions (reactive/inflammatory lesion, cyst, allergic/immunologic disorders, potentially malignant disorders, infection and others) and neoplastic lesions (benign and malignant tumors). Data were analyzed by appropriate statistics using stata11.

RESULTS

Of the 76,045 accessioned cases, 11,346 cases (14.92%) were in geriatric patients. The mean age of the patients was 72.98 ± 6.25 years. A total of 5010 cases (44.16%) were diagnosed in males, whereas 6336 cases (55.84%) were diagnosed in females. The male-to-female ratio was 0.79:1. Non-neoplastic lesions outnumbered the neoplastic counterpart. The five most prevalent oral lesions in the geriatric population in the present study in descending order of frequency were squamous cell carcinoma, focal fibrous hyperplasia (irritation fibroma), radicular cyst, osteomyelitis and epithelial dysplasia, respectively. The site of predilection was labial/buccal mucosa, followed by gingiva, mandibular bone, tongue and maxillary bone, respectively.

CONCLUSIONS

The geriatric oral lesions from the present study showed a similar trend with studies based on histopathological data, but different from the studies based on clinical data. This study also shed more light on potentially malignant disorders, as well as benign and malignant tumors.

Oral mucosal lesions: findings from the Australian National Survey of Adult Oral Health

BACKGROUND

The prevalence of oral mucosal lesions (OMLs) and factors associated with these has not previously been reported in the Australian population. This study aimed to report on the prevalence of OMLs in Australian adults and to evaluate their association with socio-demographic factors.

METHODS

This study utilized data from the Australian National Survey of Adult Oral Health 2004-06, which employs a multi-stage, stratified random sample selection procedure. Information on socio-demographics, smoking and presence of OMLs were collected using telephone interview, self-reported questionnaires and comprehensive oral examination. A multivariate regression model was generated to estimate effect of factors on the prevalence of non-ulcerated OMLs.

RESULTS

A total of 3551 dentate adult Australians had complete data for this analysis. Over 20% of study participants presented with an OML on the day of examination. The prevalence of suspected malignancy was less than 1% and over 17% for non-ulcerated OMLs. Prevalence of non-ulcerated OMLs was associated with age, gender, residential location, household income and smoking.

CONCLUSIONS

The study reported that epidemiological survey can provide useful information on OMLs. Certain population groups had a higher risk of having the condition. Preventing smoking uptake and smoking cessation can reduce the prevalence of OMLs in the population.

Oral mucosal health in liver transplant recipients and controls

Immunosuppressive drugs and other medications may predispose patients to oral diseases. Data on oral mucosal health in recipients of liver transplantation (LT) are limited. We, therefore, recruited 84 LT recipients (64 with chronic liver disease and 20 with acute liver failure) for clinical oral examinations in a cross-sectional, case-control study. Their oral health had been clinically examined before transplantation. The prevalence of oral mucosal lesions (OMLs) was assessed in groups with different etiologies of liver disease and in groups with different immunosuppressive medications, and these groups were compared to controls selected from a nationwide survey in Finland (n = 252). Risk factors for OMLs were evaluated with logistic regression. OMLs were more frequent in LT recipients versus controls (43% versus 15%, P < 0.001), and the use of steroids raised the prevalence to 53%. Drug-induced gingival overgrowth was the single most common type of lesion, and its prevalence was significantly higher for patients using cyclosporine A (CSA; 29%) versus patients using tacrolimus (TAC; 5%, P = 0.007); the prevalence was even higher with the simultaneous use of calcium channel blockers and CSA (47%) or TAC (8%, P = 0.002). Lesions with malignant potential such as drug-induced lichenoid reactions, oral lichen planus-like lesions, leukoplakias, and ulcers occurred in 13% of the patients with chronic liver disease and in 6% of the controls. Every third patient with chronic liver disease had reduced salivary flow, and more than half of all patients were positive for Candida; this risk was higher with steroids. In conclusion, the high frequency of OMLs among LT recipients can be explained not only by immunosuppressive drugs but also by other medications. Because dry mouth affects oral health and OMLs may have the potential for malignant transformation, annual oral examinations are indicated.

Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials

OBJECTIVES

The aim of this meta-analysis was to compare the efficacy of antifungal therapy with any other alternative methods used for the treatment of denture stomatitis.

DATA SOURCES

MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched, complemented by hand searching, until the first week of January 2013.

STUDY SELECTION

Included studies consisted of randomized clinical trials published in English or French, which compared antifungals with any other alternative or placebo, used for the treatment of denture stomatitis. The remission of clinical signs of denture stomatitis, and the reduction in Candida colony counts were considered as the clinical and microbiological outcomes, respectively. Random effects models were used to conduct the statistical analyses.

RESULTS

From 233 identified articles, a total of 15 manuscripts on 14 randomized controlled trials were included in systematic review and 8 in the meta-analysis. No statistically significant difference between antifungal treatment and disinfection methods was found for both clinical (OR=0.7; 95% CI: 0.32-1.36; Z=-1.14; p=0.256) and microbiological (OR=0.8; 95% CI: 0.26-2.5; Z=-0.35; p=0.724) outcomes. The meta-analysis showed a statistically significant difference between an antifungal and a placebo for the microbiological outcome (OR=0.32; 95% CI: 0.12-0.89; Z=-2.2; p=0.028), favouring the antifungals. However, there was no statistically significant difference between antifungal and placebo for the clinical outcome (OR=0.2; 95% CI: 0.04-1.04; Z=-1.9; p=0.056).

CONCLUSIONS

Disinfection agents, antiseptic mouthwashes, natural substances with antimicrobial properties, microwave disinfection and photodynamic therapy could be suggested as an adjunct or alternative to antifungal medications in the treatment of denture stomatitis.